Sex Change Industry A Boon to Small City
By James Brooke from the New York Times
Contributed by Emily Alford
November 8, 1998
TRINIDAD, Colo. -- Perched for the last century on the sandstone
facade of the First National Bank building here, three impish
gargoyles have watched the changing foot traffic on Main Street, as
this small Plains city reinvented itself again and again.
When cattle was king, this proud building of Romanesque arches
was the headquarters of a vast cattle and land empire. When coal
was king, the back offices became a health clinic for the United
Mine Workers of America.
With tourism now the king in Colorado, the former union clinic
receives medical travelers from around the world who have come to
consult a surgeon who has made this town known as "the sex-change
capital of the world."
"It's a boon to business here," the surgeon, Stanley Biber,
said of his specialty in this town 200 miles south of Denver.
"They come with families, they stay in the hotels, they eat in the
restaurants, they buy at the florists."
Biber, a vigorous 75-year-old, has performed 3,800 sex-change
operations at the 70-bed Mount San Rafael Hospital over almost 30
years. "The transsexual work means the difference between the
hospital being in the red or being in the black," he said.
Trinidad boosters wince at the sex-change label, preferring, in
one brochure, to promote their town of 10,000 people as "a pocket
of peace, plentiful clean air and pure Western Americana." They
talk of the year (1882) that Bat Masterson served as town marshal,
of modern Trinidad's four museums and of its red-brick Victorian
buildings downtown. Indeed, if ski mountains were near, this town
could be another Aspen or Telluride.
But with the nearby Comanche National Grasslands a tepid tourist
attraction, some residents are toying with taking the sex-change
industry out of Trinidad's closet.
An exhibit on Biber "would be really interesting," said Paula
Manini, director of the Trinidad History Museum, adding, "Of
course, I am sure other people in the community would think it
inappropriate."
Biber's story began here in 1954, when he came to Trinidad fresh
from service in Korea in a Mobile Army Surgical Hospital, or MASH,
unit. He grew up in Iowa and wanted to be a surgeon and a cowboy.
So after Army service, he chose Trinidad, on the Purgatoire River,
which meanders through 2.5 million acres of range land in
Colorado's largest county, Las Animas.
As the coal mines played out, Biber's medical practice with
mining families shrank. In 1969, he stumbled on a new line of work.
A social worker, whom Biber knew as a woman, but in fact was a man,
asked the surgeon if he could perform a sex-change operation. With
the confidence of a war surgeon, and with drawings obtained from a
Baltimore sex-change surgeon, Biber removed the man's penis in an
operation known as penectomy.
Soon, Biber's new practice was booming from word-of-mouth
referrals.
"When I did the first sex changes, we kept the patient charts
in the administrator's safe," Biber recalled. "Then we realized
we had to bring the local people into it."
Meeting local religious leaders, Biber lectured about what
doctors now call "gender dysphoria" -- the condition of a person
who feels trapped in the body of the wrong sex.
From 50,000 to 75,000 people live as transsexuals, or opposite
from the sex they were at birth, said Nancy Nangeroni, executive
director of the International Foundation for Gender Education, a
nonprofit group in Waltham, Mass. Since George Jorgensen became
Christine in a 1952 operation in Denmark, an estimated 25,000
Americans have had sex-changing surgery.
Marsha Botzer, a Seattle counselor of transsexuals, who came
here for sex-change surgery in 1981, recalled one friend who
arrived clutching Biber's fee in small bills in a paper bag. Biber
now charges about $11,000 for the procedure.
"Stan Biber certainly was a pioneer," Dr. Eugene Schrang, one
of a handful of American surgeons specializing in sex-change
operations, said from his clinic in Wisconsin. "He probably has
done more operations than anyone else in the field."
Through the early 1980s, when few surgeons would perform the
operations, about two-thirds of the nation's sex-change surgeries
were done at Mount San Rafael Hospital, which became a private
nonprofit hospital in 1972.
In the 1970s, unfavorable publicity about Biber and the
procedure led him and other surgeons to draw up guidelines to
eliminate sex-change surgery on demand. Most candidates now must go
through two psychiatric evaluations, live and dress in their new
role for at least a year, and undergo nine months of hormone
treatments -- testosterone for women and estrogen for men.
Biber said that he regularly turned away patients who were not
psychologically ready for surgery.
The surgeon said that only three of his 3,800 patients, all men,
had been so unhappy in their new sex that they had insisted on
switching back. In recent years, he said, there has been a major
shift in the sex of his patients, from overwhelmingly male to 50-50
today.
A pillar of the community, Dr. Biber has served as county
commissioner. He lives on a ranch east of town where he and his
wife reared nine children, and he keeps the hospital open despite a
50 percent population drop since the 1950s. As Trinidad's general
surgeon for almost half a century, Biber has performed conventional
surgeries on many of the town's residents.
"Dr. Biber's everybody's friend. Everybody knows him," said
Janet Scott, a volunteer at the A.R. Museum of Western Art, on East
Main Street near the bank building. "A lot of people begrudge him
for making Trinidad, you know, the sex-change capital of the world.
But I think he does a lot of good. Those people are very
troubled."
Now, as sex-change surgery becomes more mainstream, the road to
Trinidad is less traveled. Biber is cutting back to one surgery a
week from three, and younger surgeons are building up specialized
practices in more accessible cities, like Detroit, Montreal and
Portland, Ore.
As American transsexuals become more public and politically
active, community leaders are looking back in appreciation at the
pioneering role played by Biber in the 1970s.
"He was the one out there doing it, when no one else was," Ms.
Nangeroni said from Massachusetts. "Back then, the road to
Trinidad represented the only path available for sex
reassignment."
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